Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “BICUSPID”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources
PubMed2006

Stenosis of the bicuspid aortic valve with systemic lupus erythematosus.

We herein present a rare case of severe aortic valve stenosis with a bicuspid valve in a patient with systemic lupus erythematosus. The symptoms resulted from aortic valve stenosis, such as chest pain, dyspnea and syncope, which subsided after the insertion of an intra-aortic balloon pump. Thereafter, a calcified bicuspid aortic valve was successfully replaced with a mechanical valve. The pathological findings of the resected valve included irregular fibrotic thickening and marked calcification without any vegetation or thrombus formation. The efficacy of an intra-aortic balloon pump for the relief of symptoms associated with severe aortic valve stenosis indicates its usefulness for such critically ill patients prior to undergoing valvular surgery.

Aortic Valve↗
PubMed2001

Ascending aorta dissection associated with bicuspid aortic valve. Considerations 4 years after combined coronary artery bypass grafting and mitral valve replacement.

Aortic dissection etiology involve many factors that are difficult to identify clearly. We report a 47-year-old man who underwent a Bentall operation with reattachment of bypass grafts for a dissecting aneurysm (DeBakey type II) 4 years after combined triple coronary artery bypass grafting and mitral valve replacement. This case appeared to be associated with factors leading to dissecting aneurysm although it remains unclear which was more influential congenital bicuspid aortic valve or proximal anastomosis of venous grafts or both. This case suggests the need to consider appropriate timing in surgical intervention for cases of congenital bicuspid aortic valves and the selection of additional aortic valve replacement in initial surgery.

Aortic Dissection↗
PubMed1998

[A case report of aortic valve replacement following ruptured aneurysm of the sinus of Valsalva with bicuspid valve].

Only three cases of the combination of bicuspid aortic valve and ruptured aneurysm of the sinus of Valsalva, associated with previously repaired coarctation of aorta, have been reported. A twenty-year-old man with a sudden onset of CHF due to ruptured aneurysm of the sinus of Valsalva underwent intracardiac repair by direct closure of the sinus Valsalva in combination with patch closure of a subarterial VSD. Although, no AR was detected preoperatively, massive regurgitation occurred after the repair due to subsequent failure of aortic valve coaptation in the present of the bicuspid aortic valve, which was not diagnosed preoperatively. Aortic valve replacement with SJM 25 mm was successfully performed.

Adult↗
PubMed2005

Successful valve repair for congenital bicuspid aortic valve and degenerated prolapsed mitral valve.

A 54-year-old man with congenital bicuspid aortic valve underwent simultaneous valve repair for aortic and mitral regurgitation. Surgical technique consisted of plication of redundant aortic valve repair and mitral annuloplasty with chordal replacement. One-year follow-up transthoracic echocardiography showed no valve regurgitation. Valve repair for both bicuspid aortic valve and mitral valve regurgitation should be the first option in this subset of patients.

Aortic Valve↗
PubMed1993

Rapidity of progression of aortic stenosis in patients with congenital bicuspid aortic valves.

The rapidity of progression of aortic stenosis in patients with congenital bicuspid aortic valves, and its relation to aging and valve anatomy are not well known. To elucidate these aspects, 75 patients aged 15 to 76 years were examined by echocardiography. Aortic valve sclerosis began from the second decade, the sclerotic index progressing with age (r = 0.72; p < 0.0001). Aortic valve calcium was noted from the fourth decade. Aortic valve pressure gradient increased approximately 18 mm Hg each decade, concomitant with progression of valve sclerosis (r = 0.78; p < 0.0001). Progression of cusp sclerosis was faster in patients with anteroposteriorly located cusps than in those with right-left-located cusps (p < 0.005), and was faster in those with eccentric cusps (width ratio of major and minor cusps > or = 1.2) than in those with symmetric cusps (p < 0.05). In patients with eccentric and anteroposteriorly located cusps, aortic valve pressure gradient increased 27 mm Hg per decade. In patients with congenital bicuspid aortic valves, the progression of aortic stenosis is rapid, and the rapidity depends to some extent on the position and eccentricity of the cusps.

Adolescent↗
PubMed1995

Echocardiographic results after repair of incompetent bicuspid aortic valves.

INTRODUCTION: Valve-related complications and the necessity of anticoagulation after aortic valve replacement have led to new operative techniques for correction of aortic insufficiency (AI). Fourteen patients with bicuspid aortic valves and significant AI underwent valve repair. METHODS: Transthoracic echocardiography was performed preoperatively and 1 week postoperatively and in 10 patients who have come to follow-up so far. Operative procedures were triangular resection of one leaflet in all patients. Five patients had pericardial patch plasty in addition. RESULTS: Mean AI decreased significantly from grade 3.5 +/- 0.1 preoperatively to 0.5 +/- 0.1 postoperatively (p < 0.001). Postoperatively, 10 patients had no or trivial AI (0 to 0.5), and 2 patients had mild AI (1 to 1.5). Within the first week, 2 patients were reoperated on after echocardiography established significant AI. Ventricular dimensions decreased from preoperative to postoperative and were normal after 1 year. At follow-up, 7 patients show no change of AI; in 3 patients AI increased to moderate because of dilatation of the sinus of Valsalva or the sinotubular junction. CONCLUSIONS: Reconstruction of bicuspid aortic valves is feasible with good early results. Echocardiography shows that asymmetric sinuses may lead to early perioperative failures and postoperative dilatation of the proximal aorta to increasing AI. Operative techniques may have to consider the pathology of the proximal aorta.

Adolescent↗
PubMed1995

Bicuspid homograft reconstruction of the right ventricular outflow tract in infants.

BACKGROUND: The use of homograft tissue in cardiac surgery has progressively increased so that supply is limited, especially in the sizes required for neonatal and infant cardiac operations. METHODS: We developed in recent years a technique for surgically reducing the size of more readily available large-diameter homografts, making them suitable for right ventricular outflow tract reconstruction in small infants. This is achieved by means of a longitudinal incision of the oversized conduit, excision of one homograft cusp, and oversewing of the "bicuspid" homograft wrapped around a dilator of appropriate size. Five patients (2 male, 3 female) ranging in age from 20 days to 11 months (mean age, 8.3 months) and ranging in weight from 3.2 to 7.4 kg (mean 6.2 kg) underwent reconstruction of the right ventricular outflow tract using this surgical technique (tetralogy of Fallot/pulmonary atresia, 3 cases; truncus arteriosus, 1 case; double-outlet right ventricle, 1 case). RESULTS: There were no operative deaths and no instances of valve-related complications at a mean follow-up of 19 months. Serial echocardiography shows mild homograft stenosis in 1 patient (15 mm Hg) and mild homograft insufficiency in 1 patient. CONCLUSIONS: Although a longer follow-up is certainly required to determine whether the surgically modified bicuspid homografts will be as durable as the intact ones when positioned in the right ventricular outflow tract, we believe that this technique may represent a valuable therapeutic alternative, at least in the short term, to the use of synthetic grafts when an appropriately sized homograft is not available.

Blood Vessel Prosthesis↗
PubMed2004

An echocardiographic survey of primary school children for bicuspid aortic valve.

Primary school students (817 apparently healthy 10-year olds) were screened by transthoracic 2-dimensional echocardiography to assess for the prevalence of bicuspid aortic valve. Bicuspid aortic valve was found in 0.5% of cases, with a higher prevalence in males than females (0.75% vs 0.24%), and was significantly associated with aortic root enlargement compared with children who had tricuspid aortic valves.

Aortic Valve↗
PubMed2005

Aortic valve-sparing procedure with cusp elongation and free edge reinforcement for bicuspid aortic valve.

Aortic valve-sparing procedures demonstrate excellent valvular function at midterm. Recently authors have reported acceptable early results with aortic valve-sparing procedures on patients with regurgitant bicuspid valves. We report the case of a novel procedure to preserve bicuspid valves with a calcified raphe and root dilatation. This procedure includes raphe excision, pericardial patch elongation, free edge leaflet reinforcement, and a root reimplantation valve-sparing procedure.

Adult↗
PubMed2006

Echocardiographic prevalence of bicuspid aortic valve in the population.

INTRODUCTION: The exact prevalence of bicuspid aortic valve (BAV) is controversial. We studied the prevalence of BAV using two large independent echocardiographic databases. METHODS: We analyzed 24,265 echocardiograms performed at our academic institution between 1984 and 1998 for various clinical reasons and 1742 echocardiograms that were obtained by screening teenage athletes in Southern California. The total prevalence of BAV was calculated. RESULTS: The first database revealed a gender distribution of 11,339 (47%) male and 12,926 (53%) female patients. The second database consisted of 1172 (67%) male and 570 (33%) female athletes. The echocardiographic prevalence of BAV was 0.6% in the larger database and 0.5% in the smaller athletic database. CONCLUSION: We found the prevalence of bicuspid aortic valve in two large databases to be between 0.5% and 0.6%. This figure was consistent across different ages, in both databases.

Adolescent↗
PubMed2000

Options for repair of a bicuspid aortic valve and ascending aortic aneurysm.

BACKGROUND: Intrinsic abnormality of the aortic wall may explain the association of bicuspid aortic valves with ascending aortic aneurysms. Separate valve and graft repair of such lesions, rather than composite valve graft replacement, is more straightforward but leaves potentially abnormal sinuses behind. METHODS: Between January 1985 and January 1998, 45 patients underwent separate valve and graft (n = 27) or composite valve graft (n = 18) for an ascending aortic aneurysm and bicuspid aortic valve. Perioperative events and late results were compared. RESULTS: Patients undergoing separate valve and graft were older (mean age, 60 +/- 13 vs 42 +/- 12 years, p < 0.001) and were more likely to have purely stenotic (48% vs 6%, p = 0.003) than purely regurgitant (11% vs 72%, p < 0.001) disease. They were also more likely to require concomitant coronary artery bypass grafting (56% vs 6%, p = 0.001). There were no significant differences in operative risk and no known late complications related to recurrent aneurysms. CONCLUSIONS: Root replacement with a composite valve graft can be accomplished with low operative risk and is the first choice for repair of this lesion. Separate valve and graft repair, however, yields satisfactory early and late results and remains an acceptable option, especially when the coronary ostea are not displaced or when concomitant procedures must be performed.

Adult↗
PubMed1997

Thrombus formation on a calcific and severely stenotic bicuspid aortic valve.

We report on a case of thrombus formation on a native bicuspid aortic valve, which was found during an elective operation for aortic valve replacement. Although no apparent predisposing cause of thrombosis could be ascertained, severe calcific stenosis of the bicuspid valve and cardiac catheterization may have played a role. The patient is in excellent condition 9 months after the operation.

Aged↗
PubMed2003

Ascending aortic aneurysm associated with bicuspid and tricuspid aortic valve: involvement and clinical relevance of smooth muscle cell apoptosis and expression of cell death-initiating proteins.

OBJECTIVE: There is relationship between a dilated ascending aorta and a bicuspid aortic valve. Controversy exists concerning techniques available for surgical restoration of the functional and anatomical integrity of the aortic root. The present study was undertaken to define the histopathologic and molecular biologic condition of ascending aortic aneurysms associated with bicuspid (BAV) or tricuspid aortic valve (TAV) and the relationship to valve sparing or pulmonary autograft procedures. METHODS: Aortic aneurysm wall specimens from 20 patients (10 BAV; 10 TAV) undergoing elective repair and normal aortic tissues from organ donors (n=5) were analysed for patterns of smooth muscle cells (SMCs) and infiltrating leukocytes (immunohistochemistry), apoptosis (in situ end-labelling of DNA-fragments (TUNEL)), and expression of the death-promoting proteins perforin, Fas, and FasLigand (Immunoblotting). RESULTS: Segments from aneurysms exhibited a distinct pattern of medial destruction, elastic fragmentation, and disorientation with rarefication of SMCs. BAV wall segments contained more cells bearing markers of apoptosis than TAV specimens whereas normal aorta displayed only few apoptotic cells (P<0.05). TUNEL showed higher levels of DNA fragmentation in BAV than in TAV, and double immunostaining identified SMCs as the principal cell type displaying fragmented DNA. Immunohistochemistry confirmed expression of death-promoting mediators by infiltrating lymphocytes, and Western blotting documented their presence in BAV and TAV aneurysmal tissue, with the greatest increases seen in specimens from aneurysms associated with BAV. CONCLUSIONS: There is evidence for a molecular link between SMC apoptosis initiated by infiltration and local signal expression of immune cells and weakening of the aortic wall being more prevalent in patients with BAV. Our findings may suggest a mechanism responsible for aneurysm formation of the aorta and aortic dilatation after autograft root or sinus remodelling procedures.

Aged↗
PubMedDate not supplied

Clefted bicuspid aortic valve.

We report an unusual case of bicuspid aortic valve in a 67-year-old man who had aortic valve replacement for combined severe aortic stenosis with moderate aortic regurgitation. Both preoperative echocardiography and angiocardiography failed to recognize the bicuspid nature of the aortic valve, which was discovered only at surgical pathology examination. The atypical anatomic findings of the valve consisted of a "cleft-like" appearance of the ventral leaflet formed by the two conjoined cusps together with a fenestrated rudimental raphe.

Aged↗
PubMed2005

Dilatation of the entire thoracic aorta in patients with bicuspid aortic valve: a magnetic resonance angiography study.

BACKGROUND: The presence of a bicuspid aortic valve (BAV) might be associated with a progressive dilatation of the aortic root and ascending aorta. However, involvement of the aortic arch and descending aorta has not yet been elucidated. PATIENTS AND METHODS: Magnetic resonance angiography (MRA) was used to assess the diameter of the ascending aorta, aortic arch, and descending aorta in 28 patients with bicuspid aortic valves (mean age 30 +/- 9 years). RESULTS: Patients with BAV, but without significant aortic stenosis or regurgitation (n = 10, mean age 27 +/- 8 years, n.s. versus control) were compared with controls (n = 13, mean age 33 +/- 10 years). In the BAV-patients, aortic root diameter was 35.1 +/- 4.9 mm versus 28.9 +/- 4.8 mm in the control group (p < 0.01). The diameter of the ascending aorta was also significantly increased at the level of the pulmonary artery (35.5 +/-5.6 mm versus 27.0 +/- 4.8 mm, p < 0.001). BAV-patients with moderate or severe aortic regurgitation (n = 18, mean age 32 +/- 9 years, n.s. versus control) had a significant dilatation of the aortic root, ascending aorta at the level of the pulmonary artery (41.7 +/- 4.8 mm versus 27.0 +/- 4.8 mm in control patients, p < 0.001) and, furthermore, significantly increased diameters of the aortic arch (27.1 +/- 5.6 mm versus 21.5 +/- 1.8 mm, p < 0.01) and descending aorta (21.8 +/- 5.6 mm versus 17.0 +/- 5.6 mm, p < 0.01). CONCLUSIONS: The whole thoracic aorta is abnormally dilated in patients with BAV, particularly in patients with moderate/severe aortic regurgitation. The maximum dilatation occurs in the ascending aorta at the level of the pulmonary artery. Thus, we suggest evaluation of the entire thoracic aorta in patients with BAV.

Adult↗
PubMed2003

Bicuspid aortic valves in monozygotic twins.

Identical bicuspid valve anomalies were found in monozygotic twins. Screening echocardiography should be considered for first-degree relatives of patients with bicuspid aortic valve.

Adult↗
PubMed2005

Management of the valve and ascending aorta in adults with bicuspid aortic valve disease.

Bicuspid aortic valve (BAV) disease is the most common congenital cardiac malformation, being present in 1% to 2% of the population. It is heritable and is three to four times more likely to occur in men. The pathogenesis of BAV disease is unknown. Bicuspid valves progress to aortic stenosis or insufficiency in the majority of patients. BAV disease is associated with several anomalies of the aorta including coarctation, aneurysm formation, and dissection. Several lines of evidence suggest that aortic complications are caused by the same underlying factor that causes BAV disease, rather than being a consequence of turbulent blood flow through a stenotic valve. Several different surgical options exist for patients with BAV disease depending on the age of presentation and the size and appearance of the aorta. We herein describe our surgical management of the aortic valve and ascending aorta in patients with BAV disease.

Adult↗
PubMed2002

Bicuspid aortic valve stenosis complicated by descending aortic dissection mimicking coarctation of the aorta.

We report a rare case of bicuspid aortic stenosis complicated by an ascending aortic aneurysm and aortic dissection of DeBakey type IIIb. A 35-year-old woman was admitted to our hospital to examine her systolic murmur identified at birth. Severe aortic stenosis, dilatation of the ascending aorta, and the narrow color flow signal in the descending aorta were detected by transthoracic echocardiography. Initially, coarctation of the descending aorta was suspected, but aortic dissection, DeBakey type IIIb, was revealed by transesophageal echocardiography. Transesophageal echocardiography is indicated when only insufficient information is available on valve and aortic morphology in patients with bicuspid aortic valve.

Adult↗